The impact of social inequities on mortality due to pulmonary tuberculosis in São Luis, Maranhão, Brazil

Abstract

Introduction: Authors theorize about the relation between social inequities and death by tuberculosis. Nevertheless, the literature is restricted as to verifying the relation between these events in view of space. Therefore, the study objective was to identify areas with social inequity and its impact on the mortality rate by pulmonary tuberculosis.Methods: Ecological study, which considered deaths from pulmonary tuberculosis in the urban area of the city between 2008 and 2012, available in Mortality Information System. For the construction of the social inequity indicator, the principal component analysis was used, Multiple linear regression with the least squares method and spatial regression were used to verify the impact of inequity on mortality by TB. The spatial dependence was confirmed using Moran’s Global Index.Results: 193 deaths were identified. The social inequity was statistically associated with the mortality (R2=23.86%) in the multiple linear regression model with spatial dependence (Moran I=0.285; p<0.001), which evidenced the highest rates of mortality in the weighted areas with high and intermediate social inequity.Conclusion: Social inequity explains mortality by tuberculosis in the city investigated. To reduce the deaths by 95% until 2035, the actions the health authorities have established should not only promote better access to medical and diagnostic technologies, but also actions that promote the social development of the areas and their resident populations